week 4 Flashcards
Tibiofemoral joint- classification/ movements
classifications:
* Synovial
* Condyloid
* Biaxial
movement
Flexion 140o
* Extension 0-5o
* Internal/medial rotation 10-20degrees if flexed * External/lateral rotation 30-40 degrees if flexed
Tibiofemoral Articular Surfaces
- Femoral condyles
- Convex
- Medial & lateral
- Essentially flat
- Separated by intercondylar area
Patellofemoral- Articular Surfaces/ Classification / movements
articular surface-
* Patella surface of femur
* Articular surface of patella
classifications-
* Synovial
* Plane
* Movements
movements-
* Gliding- bone on front glides along patellar
Patellofemoral- Articular Surfaces/ Classification / movements
Articular Surfaces-
* Patella surface of femur
* Articular surface of patella (facets)
Classification-
* Classification
* Synovial
* Plane
movements-
Gliding
knee joint capsule
- Attaches to articular margins
- Femoral condyles
- Attaches to medial & lateral margins
- Tibial condyles
- Incomplete! And thin
- Anteriorly
Knee Retinacula
- Medial & lateral patellar retinaculum
- From vastus medialis & vastus
lateralis - Medial retinaculum blends with periosteum of tibia
- From vastus medialis & vastus
- Medial patellofemoral ligament (need to lean)
- Adductor tubercle to vastus medialis onto superomedial patella
Lateral retinaculum blends with iliotibial tract
Synovial Membrane of the knee
- Lines the joint capsule
- Extensive and complex
- Anteriorly attaches to patella
- Posteriorly closes off intercondylar
fossa- Does not enclose the cruciate ligaments
Communicates with some bursa
- Does not enclose the cruciate ligaments
knee bursae
- Some to be aware of:
- Pes anserine
- On medial tibia
- Suprapatellar
- Extends 6cm superior to patella
- Infrapatellar
Prepatellar
- Infrapatellar
wheredoes the fibular collarteeral ligament attach and what does it limit and prevent
- Fibular/Lateral collateral ligament
- Attaches
Lateral femoral epicondyle
Lateral surface head of fibula - Limits
Extension
Lateral rotation - Prevents
Adduction
Popliteofibular ligament (extra capsular ligament)
- Attaches
- Popliteus tendon
- Apex of head of fibula
- Limits
- Lateral rotation of the tibia
Patella ligament (extra capsular)
- From patella to tibial tuberosity
- Continuation of quadriceps tendon
- Receives the patellar retinacula
- Function
- Mechanical advantage in knee
Tibial/Medial collateral ligament (extra capsular)
- Attaches to Medial femoral epicondyle, Medial tibial condyle & shaft and Medial meniscus
- Limits- Extension, Medial rotation
- Prevents- Abduction extension
Oblique Popliteal (extra capsular)
- Strengthens central posterior joint
capsule
Is an expansion of the tendon of semimembranosus - Travels superolaterally to femur
Arcuate Popliteal (extra capsular)
Strengthens inferolateral posterior joint capsule
Is an expansion of the tendon of biceps femoris attachment
Travels superomedially over popliteus
Anterolateral ligament (extra capsular)
- Attaches
- lateral femoral condyle
- midway between anterolateral tubercle (Gerdy’s tubercle) & head of fibula
- Some sources consider it part of the ITB
stabiliser for rotation of the tibia?
Anterior Cruciate Ligament ACL (Intracapsular)
- Attaches
- anterior intercondylar area of tibia
- posteromedial surface of lateral femoral condyle
- Extra-synovial
- Limits
- anterior slide of tibia on femur
- medial rotation
- Memory tip - 3 anteriors on this slide
Posterior Cruciate Ligament PCL (intracapsule)
Attaches
* posterior intercondylar area of tibia
* lateral surface of medial femoral condyle
* lateral meniscus
* Extra-synovial
* Limits
* posterior slide of tibia on femur
* medial rotation
* Memory tip - 3 posteriors on this slide
Medial & Lateral Meniscus
- Crescent shaped wedges of fibrocartilage, thicker at ‘edges’
- Shock absorption
- Increase congruence
- Medial meniscus
- Larger, C-shaped, less mobile as more attachments
- Lateral meniscus
- Smaller, almost circular
STABILITY OF THE HIP
- Articular fit(reasonable congruency)
- Acetabular labrum (deepens the socket and increases congruency)
- Strong capsule, reinforced by capsular ligaments
- Angle of inclination (increases contact area)
Muscles
Factors contributing to MOBILITY at the hip joint
- Acetabular labrum – provides increased surface area for femoral head
- Ball and socket joint (multi-axial – three degrees of freedom)
Important steps to analyze movements
- Name the movement at the hip joint
- List the muscles acting as movers in this activity
- List the muscles acting as stabilisers
- For each of the muscles above, list all other actions they produce
- List muscles acting as synergists
stabilisers of the hip
- Iliopsoas
- Pectineus
- Deep lateral rotators
- Gluteus medius, gluteus minimus
satorius actions/ prox and distal attachment/ nerve supply
action: hip flexion /knee flexion
prox attachments: anterior superior iliac spine
distal attachment: medial surface of tibia/ medial collateral ligament of the knee
nerve supply: femoral nerve
rectus femoris actions/ prox and distal attachment/ nerve supply
action: hip flexion/ knee extension
prox attachment: anterior inferior iliac spine/ superior to the acetabulum
distal attachment: tibia tuberosity via the patellar ligament
vastus lataralis actions/ prox and distal attachment/ nerve supply
action: knee extension
prox attachment: intertrochanteric line/ lower greater trochanter/ upper half of the lateral lip of linea asparea
dist attchments: tibia tuberocity via patellar ligament/ condyle of tibia
vastus medialis actions/ prox and distal attachment/ nerve supply
action: knee extension
prox attachment: lower medial part of intertrochanteric line/ medial aspect of the proximal femoral shaft/ medial lip of the line aspera/ upper 2/3 of medial supracondylar line
dist attachment: tibia tuberocity via tendon of rec fem and patellar ligament/ medial condyle of tibia
vastus inermedialas
action: knee extension
prox attachment: upper 2/3 of anterior and lateral surface of the femur
distal attachment: tibial tuberocity via rec fem and patellar ligament
bicep femoris actions/ prox and distal attachment/ nerve supply
action: hip extension
prox attachment: medial part of asocial tuberocity and sacrotuberous ligament/ upper part of the lateral supracondylar line of the femur
distal attachment: head of fibula
semitendinous actions/ prox and distal attachment/ nerve supply
action: hip extension/ knee flexion
prox attachment: medial ischial tuberocity
distal attachment: medial surface of the upper part of the shaft of the tibia
semimembranosus actions/ prox and distal attachment/ nerve supply
action: hip extension/ knee flexion
proximal attachment: lateral aspect of ischial tuberocity
distal attachment: posteromedial surface of the medial tibial condyle
